A Research Project of the Department of Public Health · University of Basel

Durchführung eines integrierten Versorgungsprogramms für Senioren und Seniorinnen im Kanton Baselland

Background and Aim

Life expectancy is rising in Switzerland. As a result, the proportion of elderly people in need of assistance is also increasing. Support and care is offered by various providers. Older people often require a combination of services, but these are neither centralised nor coordinated, exposing older people to the risk of fragmented care.

Negative consequences of this fragmentation of care are the multiple use of services, gaps in the provision of information, inappropriate or contradictory recommendations and medication errors. This leads to insecurity, stress and strain for older people and their relatives. In addition, there are higher nursing costs due to unnecessary hospital admissions, emergency department visits and other unnecessary use of services generate unnecessary costs.

These adverse outcomes can be prevented by investing in integrated care models. INSPIRE investigates these urgent questions and shows how new care models can be implemented with high sustainability in real world care-settings.

The new care legislation “Altersbetreuungs- und Pflegegesetzt (APG)” in Canton Basel-Landschaft

In view of the demographic changes in the population in Canton Basel-Landschaft and the imminent lack of General Practitioner and health care personnel, the organisation of health care for older people in the canton has been reconsidered. On November 16th 2017, the District Administrator passed the new care legislation  Altersbetreuungs- und Pflegegesetz (APG) (valid from 1. January 2018).

The new care law specifies a reorganization of Canton BL into larger care regions, which requires collaboration at the municipal level. Advisory Centres are to be established. These will provide information onageing, age-realted matters and support and care of older persons. A nurse will provide advice and assessment, especially for persons considering admission to a nursing home, to check the indication and possibly enable ageing in place with an adequate support system. A central objective of the care regions is to develop a care concept to ensure adequate outpatient, intermediate (e.g. day clinics) and inpatient care.

INSPIRE aims to develop and implement an effective and sustainable community-based care program for senior citizens in Canton Basel-Landschaft using new methods of public health and implementation research

Project phases

The project is divided in three phases: Phase 1 encompasses the organisation of a cantonal and local stakeholder group actively engaged in the development and implementation of the integrated care model, the identification of international evidence-based literature on evaluated integrated care models, a context analysis with which the current community-based health care in Canton BL will be determined, and the development of a training course for the nursing staff of the advice centres.

Phase 2 comprises the feasibility evaluation of the INSPIRE care model, which is based on the integrated care model developed in Phase 1. In the phase 3, we will evaluate the implementation and effectiveness of the INSPIRE care model in view of the perception of person-centred care, as well as in other patient , service and implementation outcomes. Additionally, we will conduct a health-cost evaluation to determine the value of investments and affordability at the cantonal level.